Waiting-for-instruction behavior as depressive symptom in mentally retarded autistic children and adolescents and its treatment

Hiroyuki Yokoyama, Mieko Hirose, Chieko Nara, Keisuke Wakusawa, Yuki Kubota, Kazuhiro Haginoya, Shigeru Tsuchiya, Kazuie Iinuma

Research output: Contribution to journalArticlepeer-review

Abstract

We have seen 9 moderately to severely mentally-retarded autistic children and adolescents who waited for small-step instructions to perform previously acquired daily life activities (called "waiting-for-instruction" behavior). None of these patients were capable of expressing their depressive mood. All cases were considered to meet the criteria for major depressive episode described in DSM-IV. The "waiting-for-instruction" behavior was suggested to be a diagnostic key for depressive state in mentally retarded children and adolescents. GAF scales for depressive symptoms including the "waiting-for-instruction" behavior improved in 7 of these 9 cases with fluvoxamine. Risperidone and valproate sodium were useful for these symptoms in patients who were not responsive to fluvoxamine. Therefore, there is a possibility that they met the criteria for bipolar II disorder in DSM-IV.

Original languageEnglish
Pages (from-to)431-435
Number of pages5
JournalNo To Hattatsu
Volume41
Issue number6
Publication statusPublished - 2009 Dec 1

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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